镁离子对脑损伤患者脑功能的保护作用(英文)

Neuroprotective effect of magnesium on patients with brain trauma

背景:近年来,有关动物试验证明,镁离子有较好的神经保护作用而无明显的副作用,但针对脑损伤患者的研究报道较少。目的:探讨大剂量硫酸镁对脑损伤患者脑功能的保护作用。设计:设立实验对照,采用前瞻性研究方法。地点和对象:本试验在新乡医学院进行,所有试验对象来源于2001年1～6月新乡医学院第一附属医院神经外科的颅脑损伤患者。符合入选标准者共43例,随机分入治疗组和对照组。干预:治疗组患者入院后15min内静脉注射硫酸镁2g,24h内再静脉滴注硫酸镁7.8g;对照组患者不用此药。主要观察指标:3d后查血清磷酸丙酮酸水合酶(neuronspecificenoluse,NSE),2周后测格拉斯哥昏迷评分(Glasgowcomascore,GCS),6个月后测格拉斯哥治疗结果分级(Glasgowoutcomescore,GOS),进行统计学分析。结果:治疗组和对照组的NSE分别为(21.9±17.2)μg/L和(42.7±21.4)μg/L(t=3.51,P<0.01),GCS分别为12.5±3.1和10.2±2.9(t=2.52,P<0.05),GOS分别为3.8±1.7和3.2±1.5(P>0.05)。结论:大剂量硫酸镁对脑损伤患者脑功能有保护作用,近期疗效显著。

BACKGROUND:It has been proved by animal experiments in recent years that magnesium ion(Mg2+) is neuroprotective and has less side effects,but previous trials were not involved in patients with brain trauma. OBJECTIVE:To investigate the efficiency of large dose of magnesium sulfate used in the treatment of brain trauma. DESIGN:Randomized controlled trial was performed and prospective analysis was used. SETTING and PARTICIPANTS:The trial was performed in Xinxiang Medical College between January and June 2001,and all participants were recruited from Neurosurgery Nepartment of the First Affiliated Hospital.According to the standards,43 patients with brain trauma were chosen and assigned to experimental group and control group at random. INTERVENTIONS:Twenty-two patients in experimental group received 16 mmol magnesium sulfate intravenously over 15 minutes as soon as possible after admission and followed by 65 mmol over 24 hours.Twenty-one patients in control group not received magnesium sulfate. MAIN OUTCOME MEASURES:Serum neuron specific enolase(NSE),Glasgow coma score(GCS) and Glasgow outcome score(GOS) of all patients were measured after 3 days,3 weeks and 3 months respectively and the data were analyzed statistically. RESULTS:The serum NSE, GCS and GOS of the experimental group were(21.9±17.2) μg/L,12.5±3.1 and 3.8±1.7 respectively, while the serum NSE, GCS and GOS of the control group were(42.7±21.4) μg/L,10.2±2.9 and 3.2±1.5 respectively.Between 2 groups the differences of serum NSE and GCS were significant statistically(t=3.51,P< 0.01 and t=2.52,P< 0.05,respectively),while the difference of GOS was not significant(P >0.05). CONCLUSION:Large dose of magnesium sulfate is effective in treatment of patients with trauma at least within a short term.